•School of AVedicine.
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with explanatory references;
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— BY
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EDINBURGH,
MACLACHLAN & STEWART,
1831.
/
71
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.mi
^31
TO
SIR JAMES M'GRIGOR, M. D.
DIRECTOR-GENERAL OF THE MEDICAL DEPARTMENT OF THE ARMY
VC. <VC. cVC.
THIS WORK IS DEDICATED,
AS A TRIBUTE OF HIGH RESPECT FOR HIS EMINENT TALENTS, AS WELL AS OF SINCERE
ESTEEM FOR THE UNIVERSALLY ACKNOWLEDGED WORTH AND
EXCELLENCE OF HIS CHARACTER,
HIS OBLIGED AND FAITHFUL SERVANT,
JOHN G. M. BURT.
PREFACE.
Among the many useful and valuable works which
have appeared in this country, illustrative of various
branches of medical science, it appears rather extraor-
dinary that one upon Surgical Anatomy should still be a
desideratum. To supply this want has been the object
of the Editor in publishing the following Illustrations,
founded on the much and justly-admired work of M.
Blandin.
In the progress of the undertaking, it occurred to
the Editor that M. Bl an din's arrangement might be
materially improved, and some additional Plates added,
to render the illustrations more complete ; — this he has
done, and also accommodated the letter-press to the most
approved nomenclature of our medical schools.
With these explanations he submits the work to the
Medical Profession, trusting that it will prove accept-
able ; and he begs to add, that, from the high character
of Messrs J. & J. Johnstone, the engravers, he feels
quite confident that the plates will be executed in the
best style ; while, from the arrangements he has made
with them, the expense will be such as to put it within
the reach of all who may desire to obtain it.
Edinburgh, 1st December 1830.
PLATE I.
;
.
■,....
■ ■ ■
PLATE FIRST.
VIEW OF THE SUPERFICIAL ANATOMY OF THE NECK.
A. A. A
B. B. B,
C.
D.
E.
F.
G.
H. H.
I.
J.J.
K. K.
K\
L.
M.
N. N.
O. O.
P.
Q.
s.
T.
U.
V.
Lateral portion of the head, from the occiput to
the ear, and from thence to the chin.
Clavicle.
Portion of the great pectoral muscle.
Portion of the deltoid muscle.
Triangular space formed by the two preceding
muscles with the clavicle, and filled with cel-
lular substance, perforated for the transmission
of the two following vessels: —
Acromial artery,
Cephalic vein.
Sterno-mastoid muscle.
Anterior margin of the trapezius.
Two digitations of the levator-anguli-scapulas.
The integuments reflected backwards.
The platysma myoides also reflected.
Omo-hyoid muscle.
Portion of the deep-seated layer of the cervical
fascia, arising from the middle tendon of the
preceding muscle, and prolonging itself to the
clavicle, against which it binds down the supra-
scapular vessels.
Anterior scalenus muscle.
Fibres of the posterior scalenus muscle.
Superior digitations of the serratus magnus.
Subclavian artery, passing out between the scaleni
muscles, and giving of}', in the present case, as
is not uncommon, a large artery, which crosses
the brachial plexus, and represents the deep
branch of the transverse cervical.
Portion of the first rib, over which we can with
facility apply a ligature to the subclavian
artery.
Branch already pointed out, which is given off by
the subclavian artery.
Artery which arises from the subclavian, and re-
presents the ordinary tract of the transverse
cervical, of which we have in this instance the
superficial branch only.
Supra-scapular artery, lying close to the clavicle.
Portion of the axillary vein in front of the ante-
rior scalenus muscle.
X. External jugular vein, single, and of greater size
below, dividing on the sterno-mastoid. This
high division of the external jugular is com-
mon, but not constant.
Y. Termination of the anterior jugular vein, situated
under the sterno-mastoid muscle, in front of
the deep layer of the cervical fascia, and join-
ing the external jugular.
Z. Common trunk of the transverse cervical and
supra-scapular veins, lying close to the clavicle.
a. Brachial plexus on the outer side of the axil-
lary artery.
b. Cord of communication of the cervical and
brachial plexuses.
c. c. Phrenic nerve, crossing the direction of the an-
terior scalenus muscle.
d. Suprascapular nerve.
e. Mastoidean nerve of the superficial cervical plexus.
f. f. Auricular nerve of the same plexus.
g. Three cervical nerves of the superficial cervical
plexus, forming a curve on the posterior bor-
der of the sterno-mastoid muscle,
h. Branch from the superficial cervical plexus, en-
twining the jugular vein in the middle of the
neck,
i. Deep cervical branch of the superficial cervical
plexus, passing towards the trapezius.
Descending supra-clavicular filaments of the cer-
vical plexus.
Descending supra-acromial filaments of the same
plexus.
Mastoidean and fascial lymphatic vessels.
Lymphatic ganglion exterior to the sterno-mas-
toid muscle.
Supra-clavicular lymphatic ganglia.
Lymphatic vessels of the neck.
Lymphatic vessels which follow the anterior ju-
gular vein, and which have their origin at the
anterior part of the neck,
q. q. Superficial lymphatic vessels of the thorax, which
terminate in the supra-clavicular ganglia.
J-
J- J
k.
k.
1.
in
1.
ii.
n.
0.
P-
PLATE SECOND.
VIEW OF THE DEEP-SEATED ANATOMY OF THE NECK.
A. Portion of the ear.
B. Portion of the cheek.
C. Chin drawn upwards.
D. Portion of the occiput.
E. Superior extremity of the sternum.
F. Right clavicular region elevated.
F\ Left clavicle directed horizontally.
G. Right side of the neck, on which we see in profile
the relative situations of the different parts.
H. H. The integuments.
I. Subcutaneous cellular substance.
J. J. Layer formed above by the platysma myoides, and
below by the superficial cervical fascia.
K. Place where the cervical fascia, in the upper part
single, divides into two principal layers.
K'. Anterior and posterior layers of the cervical fascia.
L. Inferior extremity of the sterno-mastoid muscle,
situated between the two layers of the cervical
fascia.
L'. The anterior external jugular vein, slightly de-
veloped, and confined between the two layers
of the cervical fascia.
L". Ganglia and lymphatics situated between the
layers of the cervical fascia.
M. Fatty cushion lying below the upper part of the
platysma myoides.
N. Sterno-hyoid muscle.
O. Sterno-thyroid muscle.
P. Left side of the neck, where the different organs
have been completely laid bare, and are seen
nearly in front.
Q. Hyoid bone.
R. Inferior maxillary bone.
5. S. The skin reflected backwards.
S'. S'. The platysma myoides also reflected backwards.
T. Hook applied to the sterno-mastoid muscle, and
drawn outwards, to display the parts naturally
concealed.
U. Omo-hyoid muscle.
V. Sterno-hyoid and thyroid muscles cut across.
V. Their inferior extremities.
X. Crico-thyroid muscle.
X'. Thyro-hyoid muscle.
Y. Anterior belly of the digastric muscle,
Y\ Posterior belly of the same muscle.
Y". Pulley of the muscle.
Y"\ Fibrous lamina, which proceeds from the tendon
of the muscle.
Z. Styio-hyoid muscle.
Z'. Stylo-glossus muscle.
6. Portion of the inferior constrictor muscle of the
pharynx.
a. Portion of the hyo-glossus muscle.
b. Mylo-hyoid muscle.
e. Portion of the masseter muscle.
d. Thyro-hyoid space.
o.
o'.
P-
P'-
q-
q'-
r.
t.
t\
x.
x\
y- y-
z. z.
].
2.
3.
5.5.
6.
7.
8.
9.
10.
11.
12.
13.
14..
15.15.15
16.
17.
18.
19.
20.
Thyroid cartilage.
Crico-thyroid space, filled by an elastic membrane,
exhibiting small vascular openings.
Cricoid cartilage.
Thyroid body.
Trachea.
GSsophagus inclining to the left.
Portion of the brachio cephalic trunk.
Left common carotid artery.
Inferior thyroid artery, passing transversely be-
hind the common carotid, and in front of the
commencement of the oesophagus.
Division of the common carotid.
External carotid artery.
Internal carotid artery.
Superior thyroid artery.
Crico-thyroid artery.
Fascial artery.
Sub-mental branch of the fascial artery.
Lingual artery.
Internal jugular vein.
Anterior jugular vein.
Fascial vein.
Temporal vein, leaving the parotid.
Lingual vein.
Lateral thyroid vein.
Filaments from the cervico-fascial branch of the
fascial nerve.
Mylo-hyoidean filament of the inferior dental and
spinal nerves.
Hypo-glossal, or ninth pair of cerebral nerves.
Its descending branch.
Arch formed by the preceding nerve, and the de-
scending internal branch of the cervical plexus.
Sterno-hyoidean filament of the hypo-glossal
nerve.
Pneumo-gastric nerve.
Superior laryngeal nerve of the left pneumo-gas-
tric, dividing itself into two branches.
Cardiac branch of the pneumo-gastric nerve.
Inferior laryngeal or left recurrent nerve, placed
in front of the oesophagus.
Cervical portion of the great sympathetic.
Termination of the superior cervical ganglion.
Middle cervical ganglion, placed on the inferior
curvature of the thyroid artery.
Communicating filament of the great sympathetic
with the cervical nerves.
Cardiac nerve, superficial at its origin.
Origin of the middle cardiac nerve.
Lymphatic ganglia.
Parotidean lymphatic vessels.
Mastoidean do.
Fascial do.
Sub-mental do.
Cervical do.
PLATE II.
S-f.
I'LATi; III
PLATE THIRD.
PERPENDICULAR SECTION OF THE HEAD AND NECK, TO SHOW THE RELATIVE SITUATIONS'
OF THE CAVITIES OF THE NOSE, MOUTH, LARYNX, AND PHARYNX.
A.
B.
B.
B.
('.
C.
I).
E.
E.
E.
E
F.
G.
II.
I.
J.
K.
L.
M.
N.
O.
P.
Q.
It.
S.
T.
U.
V.
X.
Y.
Z.
a. a. a. a.
b.
c.
e. c. e. e. e.
f. f. f. f. f.
g-g-g-g-g
1. 1. i. i. i. i
J- J- J-
k. k.
1.
m.
Cut edge of the frontal bone.
Cut edge of the integuments.
Frontal sinuses.
Cut edge of the nasal hone.
Left surface of the septum narium, covered
by the pituitary membrane.
Anterior portion of the fall cerebri.
Cut edge of the cribriform plate of the eth-
moid bone.
Irregular surface of the right orbitar process
of the frontal bone.
Anterior clinoid process.
Sella turcica.
Part of the left sphenoidal sinus, with the
septum which divides it from that of the
opposite side.
Cut edge of the posterior clinoid process.
Cut edge of the body of the sphenoid bone.
Cut edge of the basilar portion of the occi-
pital bone.
Opening for the passage of the nerve of the
fifth pair.
Meatus auditorius interims, for the passage
of the auditory and fascial nerves.
Foramen lacerum for the passage of the
nerve of the eighth pair and lateral sinus.
Foramen condyloideum anterius, for the pas-
sage of the nerve of the ninth pair.
Round opening of the dura mater, at which
the vertebral artery enters the cranium.
Edge of the tentorium.
Posterior portion of the falx cerebri.
Part from which the tentorium has been de-
tached on the left side.
Lateral sinus divided.
Cut edge of the occipital bone.
Falx cerebelli.
Cut edges of the lining membrane of the
spinal canal.
Cut edge of the ligament which connects the
processus dentatus to the occiput.
Cut edge of the circular ligament which
connects the processus dentatus to the
atlas.
Cut edge of the processus dentatus.
e. Cut edges of the bodies of the second, third,
fourth, fifth, sixth, and seventh vertebra;.
Intervertebral substance.
Openings for the passage of the first, second,
third, fourth, fifth, sixth, and seventh cer-
vical nerves.
Cut edge of the back of the atlas.
Cut edges of the spinous processes of the
second, third, fourth, fifth, sixth, and se-
venth vertebra.
Muscles of the back of the neck.
Cut edge of the pharynx.
Sacculus ccecus of the pharynx.
Membrane which sometimes divides the sac-
culus at this part.
Eminence caused by a piece of cartilage
at the extremity of the eustachian tube.
g-g
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27. 27.
28.
29.
30. 30.
31.
Opening of the eustachian tube.
Cut edge of the palate bone.
Cut edge of the palatine process of the su-
perior maxillary bone.
Part of the cavity for the reception of the
fang of the first left incisor tooth of the
upper jaw.
Cut edge of the palatine membrane.
Cut edge of the upper lip.
Palate.
Cut edge of the soft palate.
Uvula.
Folds of the membrane of the mouth.
Internal lining of the cheek.
Olosso-palatine arch.
Tonsil.
Pharyngo-palatine arch.
Cut edge of the tongue.
Genio-glossus muscle.
Frenum of the tongue.
Part of the cavity for the reception of the
fang of the first left incisor tooth of the
lower jaw.
Cut edge of the under lip.
Cut edge of the inferior maxillary bone.
Genio-hyoideus muscle.
Cut edge of the os-hyoides.
Ligament which connects the os-hyoides to
the thyroid cartilage.
Frenum of the epiglottis.
Dorsum of the tongue.
Epiglottis.
Eminence caused by the posterior extremity
of the corner of the os-hyoides.
Cut edge of the epiglottis.
Line denoting the situation of the ligament
which connects the posterior extremity of
the corner of the os-hyoides to the supe-
rior corner of the thyroid cartilage.
Situation of the superior corner of the thy-
roid cartilage.
Corniculum of the larynx.
Cut edge of the aretenoid cartilage.
Base of the aretenoid cartilage.
Ventricle of the larynx.
Cut edge of the thyroid cartilage, in front.
Vocal chord.
Cut edge of the broad posterior portion of
the cricoid cartilage.
Cut edge of the ligament which connects
the small anterior portion of the cricoid
cartilage to the inferior part of the thy-
roid cartilage in front.
Cut edge of the small anterior portion of the
cricoid cartilage.
Cut edges of the cartilaginous rings of the
trachea.
Internal surface of the trachea.
Cut edge of the membranous part of the
trachea.
Cut edges of the oesophagus.
Muscles in front of the neck.
PLATE FOURTH.
THE EYE.
THIS PLATE IS INTENDED TO ILLUSTRATE THOSE PARTS OF THE EYE MOST COMMONLY
CONCERNED IN SURGICAL OPERATIONS.
FIGURE FIRST
Represents the Eye-ball; part of the Cornea, Sclero-
tica, and Iris, being removed.
The tunica conjunctiva.
The cornea.
The iris.
The sclerotica.
The crystalline lens.
The optic nerve.
One of the ciliary processes.
The zonula lucida, or space between the anterior
extremities of the ciliary processes and margin
of the crystalline lens.
The anterior termination of the retina.
The part of the hyaloid membrane, which forms
the canal of Petit, to which the pigmentum
nigrum of the choroid coat and ciliary pro-
cesses adhere.
A. A.
B.
C.
D. D.
E.
F.
G.
H.
I.I.
K.
FIGURE SECOND
Represents one-half of the Coats of the Eye, from
•which the humours have been removed.
A.
B. B.
C. C.
D.
E.
F.
The cornea.
The sclerotica.
The anterior termination of the choroid coat,
where the ciliary ligament commences.
The ciliary ligament and processes, to which the
iris is attached.
The iris.
The optic nerve, which expands within the cho-
roid coat forming the retina.
FIGURE THIRD
Represents the Eye-ball, from which the Cornea
and anterior half of the Sclerotica have been
removed, by which the anterior part of the Cho-
roid Coat, the Ciliary Ligament, the Iris, and
the Crystalline Lens, are seen anteriorly.
The sclerotica.
The choroid coat.
The ciliary ligament.
The iris, having one-half torn down.
The ciliary nerves.
The crystalline lens.
The anterior part of the vitreous humour which
occupies the space between the ciliary pro-
cesses and margin of the lens.
FIGURE FOURTH
Represents one-half of the right Orbit xvith its
contents, divided perpendicularly.
A. A. A
15. B.
C. D.
E. E.
A. The bony orbit.
The integuments, covering the anterior of the
orbit.
The upper and lower eyelids. The two black
points at their nasal extremities, represent
the orifices of the lateral lacrymal canals,
called the puncts lacrymalia:.
The eye-ball, showing its coats, and humours
contained within them.
The optic nerve.
The levator palpebral superioris, the tendon of
which is inserted into the tarsal cartilage of
the upper eyelid.
The levator oculi, the tendon of which is in-
serted into the sclerotica about the eighth of
an inch from the margin of the cornea.
The depressor oculi.
The adductor oculi.
The conjunctiva lining the eyelids, and cover-
ing the anterior surface of the eye-ball, form-
ing a pouch by its reflection.
FIGURE FIFTH
Represents the anterior half of the Coats of the
Eye, seen from behind, the Humours being re-
moved.
The sclerotica.
The choroid coat.
The ciliary processes.
The iris, having iu, circular aperture called the
pupil.
A.
B. B.
C C.
D.
FIGURE SIXTH
Represents the Vitreous and Crystalline Humours,
as taken from the Coats of the Eye, represented
in Figure Fifth.
A. A.
B. B.
C. C.
1).
The hyaloid membrane of the vitreous humour
covered by a portion of the retina.
The part of the hyaloid membrane, which forms
the canal of Petit, to which some of the pig-
ment of the ciliary processes and choroid coat
adheres.
The space between the ciliary processes and
margin of the lens, occupied by the anterior
part of the vitreous humour, upon the hy-
aloid membrane of which, the vessels, for
the nourishment of the lens, proceed to the
capsule.
The crystalline lens.
FIGURE SEVENTH
Represents an Anterior View of the Eyelids and
Lacrymal Organs, upon the removal of the In-
teguments and Orbicularis Palpebrarum.
A. B. C. D. The situation of the margin of the bony orbit.
E. The inner angle of the eye.
F. The outer angle.
G. II. The punctae lacrymalia1, or orifices of the late-
ral lacrymal canals which lead to the lacrymal
sac.
1). I. The lacrymal sac.
I. J. The nasal duct.
J. The lower orifice of the nasal duct, entering
the lower and lateral part of the nose, at the
fossa formed by the inferior spongy bone
(K), and superior maxillary bone (J).
j The orifices of the sebaceous ducts, leading
from the meibomian glands, represented by
a dotted line.
]\[_ The cartilage of the upper eyelid.
N. The cartilage of the lower eyelid.
O. The lacrymal gland.
Tig, I.
IM.ATK IV.
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PLATE V.
PLATE FIFTH.
FRONT VIEW OF THE AXILLA, THE ARM BEING SLIGHTLY ELEVATED.
A.
B.
C. C.
D.
E.
F.
G.
H.
I.
J.
K.
L.
M.
N.
Portion of the inner side of the arm.
Hair of the arm-pit.
Flaps of the great pectoral muscle, the origin
reflected upon the chest, the insertion upon
the deltoid muscle.
Lesser pectoral muscle.
Anterior portion of the deltoid muscle.
Sub-clavius muscle.
Coraco-brachialis muscle.
Lateral portion of the thorax.
Clavicle.
Coraco-clavicular aponeurosis, covering the sub-
clavius muscle ; the internal and superior por-
tions only of this aponeurosis seen here, the
rest having been raised to show the vessels and
nerves.
Subclavian artery.
Portion of the subclavian artery, where the liga-
ture should be applied.
Subclavian vein.
Axillary artery.
O.
P.
Q.
Q'. Q'.
R.
T.
U. U.
V. V.
w.
X.
Axillary vein.
Cephalic vein.
Median nerve, with its two roots,
Which embrace the artery.
Musculocutaneous nerve, following the course
of the coraco-brachialis muscle, from the side
of which a few fibres have been cut away to
show the nerve.
The ulnar nerve, lying close upon the artery.
The internal cutaneous nerve, separated from
the preceding by the axillary vein.
Posterior thoracic nerve in the bottom of the
cavity, and attached to the serratus magnus
muscle.
Brachial branches of the intercostal nerves.
Acromial artery arising from the subclavian, be-
hind the lesser pectoral muscle.
Coraco-acromian ligament slipping under the
deltoid muscle.
Small arterial and veinous branches of the axilla.
Head of the humerus.
PLATE SIXTH.
THE AXILLA VIEWED FROM BELOW, THE ARM BEING STRONGLY ELEVATED.
A. Portion of the arm.
B. Portion of the costal region of the thorax, form-
ing the internal boundary or wall of the
axilla.
C. C. The ribs cut obliquely.
D. Aorta.
E. Vena cava inferior.
F. F. Two superior digitations of the serratus mag-
nus.
G. Posterior thoracic, or external respiratory nerve of
Charles Bell, passing over the serratus mag-
nus.
H. Long thoracic artery passing like the preceding
nerve upon the serratus magnus, but carried
much farther forward, and encircled with lym-
phatic ganglions, which receive,
I. I. Lymphatic vessels passing out between the inter-
costal spaces,
J. J. Bundles of the lymphatic vessels of the mamma,
K. Bundles of lymphatic vessels, coming from the
upper part of the anterior abdominal parietes.
L. Anterior boundary of the axilla, in which we
find,
M. M. The skin and breast,
N. N. Subcutaneous tissue,
O. Portion of the cephalic vein,
P. Pectoralis major,
Q. Pectoralis minor,
K. Anterior thoracic vessels and nerve,
S. Vessels and nerve of the pectoralis minor.
T. Posterior wall of the axilla, on which the skin
has been reflected from the base.
U. Hairy skin from the base of the axilla.
V. Subcutaneous cellular tissue.
X. X. Latissimus dorsi, held with a hook.
V. Longissimus dorsi.
Z. Tendon of the long head of the triceps, near its
insertion under the glenoid cavity.
a.
b.
c.
d.
e. e.
f. f.
g-
h.
k*.
1. 1.
m.
n. n.
o.
p. p.
y- y-
z. z.
Situation where the naked fibrous capsule of the
shoulder joint is seen, very feeble.
Tendon of the subscapular muscle, passing on the
inner side of the joint.
Lymphatic ganglion, which receives,
Lymphatics of the neck,
Lymphatics of the back,
Lymphatics of the superior part of the loins.
Circumflex vessels and nerves, passing between
the triceps and humerus.
Anterior or common scapular vessels.
Transverse and dorsal branches of the anterior
scapular vessels.
Axillary and descending branches of the common
scapular vessels.
Great subscapular nerve which accompanies the
descending branch of the common scapular
artery.
Posterior angle of the axilla.
Two brachial lymphatic ganglions.
Axillary vein, placed in front of the artery, and
formed by the union of the following veins : —
Two brachial veins,
Basilic vein.
Axillary artery, placed between the vein and the
plexus.
Place where the artery is embraced by the bra-
chial plexus.
Brachial plexus, placed behind the artery.
Median nerve.
Ulnar nerve.
Internal cutaneous and radial nerves united.
Situation where the bundles of vessels and nerves
occupy the anterior angle of this cavity.
Situation where the axillary vessels and nerves
are placed in the external angle of the axilla.
Brachial filaments of the intercostal nerves.
Small ramifications of the intercostal arteries.
PLATE VI
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i
PLATE SEVENTH.
THE ANTERIOR ASPECT OF THE REGION OF THE ELBOW, IN WHICH THE VEINS HAVE BEEN
STRONGLY INJECTED, TO SHOW, BY THEIR NODOSITIES, THE COMPARATIVE
NUiMBER OF VALVES IN THE SUPERFICIAL AND DEEP-SEATED VEINS.
FIGURE FIRST.
Superficial parts of the Bend of the Arm.
A. A. The termination of the brachial aponeurosis.
B. B. Commencement of the anti-brachial aponeurosis.
C. Fibres of the brachial aponeurosis, which have an
inclination outwards towards the bundle of
muscles on the outside of the elbow.
D. Oblique direction inwards of the greater part of
the aponeurosis.
E. Place where the tendon of the biceps is partially
covered by a thin fibrous aponeurosis.
F. The superficial radial vein, bound down in its
small sheath.
G. Fibrous expansion, detached from the biceps, and
becoming attached to the internal part of the
fascia.
II. The inner condyle.
I. The superficial radial vein.
K. Cephalic vein.
L. The anterior superficial ulnar vein.
M. The posterior superficial ulnar vein.
N. Origin of the basilic vein.
O. The common median vein, very prominent, and
enclosed in a small sheath.
P. Veinous branches which perforate the fascia, and
which unite the deep-seated radial veins with
the origin of the median cephalic and basilic.
Q, The median basilic vein.
It. The median cephalic vein.
S. S. Brachial veins, which we perceive by means of an
aperture in the fascia of the elbow, purposely
made to display them.
T. T. T. Superficial anormal veins.
U. Internal cutaneous nerve, dividing itself at the
elbow into a considerable number of branches,
entwining the median basilic, and basilic veins.
V. The filaments of a cutaneous nerve, given off very
high up by the ulnar nerve, sometimes even by
the brachial plexus.
X. The external cutaneous, or musculo-cutaneous
nerve, issuing from its deep position outside of
the biceps, passing under the median cephalic
vein, and slipping, without dividing itself, into
the sheath of the median vein.
Y. The brachial artery, seen between the two veins.
Small branch of the brachial, of which one branch
remains subfascial, whilst the other becomes
subcutaneous, a branch which appears to be the
rudiment of the variety in which the ulnar ar-
tery passes superficially in this region.
Cutaneous branch of the radial nerve.
Deep
A.
B.
C.
D. D.
E.
F.
G.
H.H.H.
I. I. I.
K. K.
L. L.
M. M.
N.
O. P.
O.
P.
Q.
R.
S.
T.
U.
V.
X.
Z.
FIGURE SECOND.
■seated Parts of the Bend of the Arm.
Tendon of the biceps.
Flattened tendon of the brachialis internus.
Internal border of the triceps muscle.
Supinator longus muscle.
External radial muscles.
Small supinator muscle, presenting an aperture
perforated by the dorsal branch of the radial
nerve.
Round pronator muscle, and bundle of muscles
on the inner side of the elbow.
Brachial artery, situated on the outer side of the
median nerve, and entwined by its veins.
Origins of the radial and ulnar arteries.
Deep-seated radial and ulnar veins.
Brachial veins.
Radial veins, surrounding a portion where we see
the brachial artery.
Origin of the anterior recurrent of the epicondyle,
which passes at this point under the tendon of
the biceps. It is not in this case the normal
disposition.
Anterior arterial arch of the inner condyle, form-
ed by the two following branches,
Internal collateral artery of the arm,
Anterior recurrent ulnar artery.
Artery with the ulnar nerve passing behind the
inner condyle.
Divided trunk of the musculo-cutaneous nerve.
Median nerve, drawn a little to the inner side.
Place where the median nerve passes between the
two bundles of the round pronator muscles.
Ulnar nerve.
Radial nerve, dividing into two branches, viz.
Anterior branch,
Posterior branch, disappearing under the short
supinator muscle.
PLATE EIGHTH
THE FINGERS.
A.
B.
C.
I).
F.
G.
H.
I.
K.
L.
31.
N.
<).
E
P. P.
Q.
R.
S.
T.
U.
X. X
FIGURE FIRST.
ANTERIOR ASPECT OF THE FINGERS.
No. 1 — Exterior Surface of Ike Finger.
Line of the last phalangien articulation.
Line of the first phalangien articulation.
Line of the metacarpo-phalangien articulation.
No. 2. — Skeleton of the Finger.
Lateral articular ligaments.
Anterior ligament, developed by a sesamoid bone.
No. 3. — Sheath of the Flexor Tendons laid
open, to show the Tendons.
Tendon of the flexor digitorum sublimis.
Tendon of the flexor digitorum profundus.
Situation where the flexor tendon becomes flat,
afterwards separating into two bundles, the
tendon of the flexor profundus passing between
them.
Cut border of the sheath.
The artery and nerve in their natural positions —
the nerve lying on the inner side.
No. 4 — View, with the Sheath entire.
Anterior aspect of the sheath.
N. Origin and termination of the sheath.
0. Situations where the fibrous membrane of the
sheath forms crucial bands.
Rounded openings in the sheath for the trans-
mission of blood-vessels, and situated over the
metacarpo-phalangien articulation.
Situations where the sheath is wanting, showing
the naked tendon of the flexor profundus.
Trunks of the arteries.
Artery and nerve ; — the nerve is seen outside the
artery, in consequence of the reflection of the
integuments.
Arch formed by the artery on the last phalanx,
and the non-formation of the arch by the cor-
responding nerve.
No. 5 Veins of the Finger.
Veinous branch, by which the anterior plexus of
veins of the finger communicates with those of
the palm of the hand.
X. Veinous branches situated over the lines of arti-
culation, and communicating laterally with the
digital plexus.
FIGURE SECOND.
POSTERIOR ASPECT OF THE FINGERS.
No. 1 Exterior Surface of the Finger.
A. B. C. Line of the phalangien and metacarpo-phalangien
articulations.
No. 2. — Skeleton of the Finger.
I). E. Digital articulations deprived of their posterior
ligaments, and showing one of their lateral li-
gaments.
No. 3. — Fibrous Membrane of the Extensor
Tendons of the Fingers.
F. Extensor tendon, narrow at the metacarpo-pha-
langien articulation.
G. Situation where the extensor tendon divides into
three bundles, viz. —
H. Middle phalangien bundle,
I. I. I. Lateral phalangettien bundles, which afterwards
reunite.
K. K. Tendons of the lumbricales and interossei mus-
cles.
No. 4 — Vessels and Nerves.
L. L. L. Arterial branches, directed obliquely backwards
over the lines of the digital articulations.
M. Arterial arch at the root of the nail, into which
it sends many ramifications.
O. P. Corresponding nerves, among which, for this fin-
ger especially, are O. from the radial, and P.
from the dorsal branch of the ulnar nerve.
Q. Q. Q. Veinous trunks coming from the fingers, and
forming the veinous arch of the back of the
hand.
R. Tendinous expansion, which unites the two ex-
tensor tendons.
No. 5. — Plexus of Veins.
X. X. X. Veins communicating laterally between the an-
terior and posterior veins.
FIGURE THIRD.
PERPENDICULAR AND LONGITUDINAL SECTION
OF THE LAST PHALANX, TO SHOW THE FOR-
MATION OF THE NAIL.
a. Section of the bone.
b. Anterior ligament of the last phalangien articula-
tion, in which will be observed a sesamoid bone.
Termination of the phalangettien extensor tendon.
Termination of the phalangettien flexor tendon.
The skin on the anterior and posterior surfaces of
the finger.
Sinus, formed by the skin, in reflecting itself upon
the nail.
Point where the reflection of the skin commences
on the back of the nail.
The nail.
Cellular tissue of the pulp of the finger.
Tendinous fibres, which connect the skin at the
extremity of the finger with the anterior sur-
face of the bone.
c.
d.
e. e.
FIGURE FOURTH.
EXTERIOR AND SIDE VIEW OF THE FINGER,
WHICH IS BENT AT THE DIFFERENT ARTICU-
LATIONS, TO SHOW, IN THAT POSITION, THE
LINES OF THE ARTICULATIONS A. B. C.
PI.ATK Mil.
{
PLATE IX
PLATE NINTH.
INGUINAL AND CRURAL CANALS, SEEN EXTERIORLY.
A.
B.
c.
D.
E. E.
F.
G.
H.
I.
J.
K. K.
L.
M.
N.
O.
P.
Q.
S. S.
T.
U. U.
Portion of the thigh.
Penis.
Scrotum.
Hair of the pubis.
Portion of the anterior parietes of the abdomen.
Anterior and superior spinous process of the
ilium.
Rectus muscle in its sheath.
Pyramidal muscle, also in its sheath.
Aponeurosis of the external oblique.
Hook raising a portion of the fascia of the ex-
ternal oblique, detached above from the cru-
ral arch in the situation where it forms the
anterior wall of the inguinal canal.
Crural arch.
Inguinal ring traversed by the spermatic cord,
and giving off from its margin a fibrous ex-
pansion to the cord.
Fibrous expansion detached from the margin
of the inguinal ring.
Internal or superior pillar of the ring.
External or inferior pillar of the ring.
Situation where the crural arch connects itself
with the whole thickness of the fascia lata.
Situation where the crural arch adheres only
to the superficial fibres of the aponeurosis of
the fascia lata, fibres which are here detached
and turned outwards.
Passage opened above, which forms the crural
arch, and which, in continuing itself back-
wards and upwards with the fascia transver-
salis, forms the passage which constitutes the
inguinal canal.
Fascia transversalis, which forms the posterior
wall of the inguinal canal in a situation
where, of the three muscles of the abdomen,
we find only the external oblique.
Situation where the fascia transversalis arises
from the external border of the rectus.
Inferior conjoined and horizontal edges of the
internal oblique and transversalis muscles.
V. V.V.V. V. Loops of the cremaster muscle, formed by
prolongations on the cord from the inferior
border of the internal oblique and transver-
salis muscles.
X. Spermatic cord.
Y. Ilio-scrotal nerve of the lumbar plexus.
Z. Z. Z. Skin and adipose tissue of the parietes of the
abdomen reflected downwards.
&. &. Aponeurosis of the fascia superficialis.
a. Cord knitted to the aponeurosis of the fascia
superficialis, detached from the parietes of
the abdomen, and reflected upon the thigh
and hip.
b. b. b. Vessels of the integuments of the abdomen.
c. External superficial vessels of the genitals.
d. d. Anterior parietes of the crural canal, incised
and reflected from within outwards to shew
the canal.
e. Large lymphatic ganglion situated over the
crural canal.
f. Openings of the anterior parietes of the crural
canal, which are traversed by the lymphatic
vessels.
g. External parietes of the crural canal formed
by the deep fibres of the fascia lata, sup-
ported upon the psoas and iliacus internus
muscles,
h. Opening made at the external part of the cru-
ral canal, to shew the crural nerve, situated
immediately behind it in the sheath of the
psoas muscles.
i. Femoral artery lying on the outer side of the
femoral vein.
Femoral vein.
Lymphatic ganglion in the internal part of the
superior opening of the crural canal.
Internal saphena vein.
Inferior opening of the crural canal, crossed by
the internal saphena vein.
Falciform bundle of fibres, situated at the junc-
tion of the saphena and femoral veins.
PLATE TENTH.
POSTERIOR VIEW OF THE ANTERIOR ABDOMINAL PARIETES, TO SHOW THE SUPERIOR ORIFICES
OF THE INGUINAL AND CRURAL CANALS ; AND ALSO A PERPENDICULAR AND TRANS-
VERSE SECTION OF THE PELVIS, TO SHOW THE INTERNAL ILIAC REGION
AND THE CONNEXION OF THE PERINEAL APONEUROSIS WITH
THE APONEUROSES OF THE CAVITY OF THE PELVIS.
A.
A.
B.
B. B. B
C.
C.
I).
D.
E.
E.
!•'.
F.
G.
G.
M
H.
I.
I.
J.
J.
K
K.
L.
L.
M
N.
O.
O'.
P.
Q.
R.
S.
s\
T.
V.
V.
X.
b.
b\
Section of the upper part of the femnr.
Perpendicular section of the iliac bones, from
the anterior and superior spine of the ilium
to the tuberosities of the ischium.
Anterior superior spines of the ilium.
Tuberosities of the ischia.
Inferior portion of the anterior abdominal
parietes, formed by
The skin,
Subcutaneous cellular tissue,
Fascia superficialis,
Aponeurosis of the external oblique muscle,
Internal oblique muscle,
Transversalis muscle,
Transversalis fascia, very thin,
Right side of the abdominal parietes on which
the peritoneum still remains.
Place where the peritoneum in the foetus forces
itself within the inguinal canal, and where,
in the adult, it presents a wrinkled cicatrix.
Tract of the epigastric vessels.
Tract of the vas deferens.
Projection of the umbilical artery.
Inguinal fossa outside of the peritoneum.
Left side of the anterior abdominal parietes,
on which, the peritoneum having been re-
moved, we see distinctly the fascia transver-
salis.
Situation where the posterior part of the
sheath of the rectus muscle is wanting.
Place where the sheath of the rectus muscle is
complete.
Place where the aponeurosis of the fascia
transversalis accompanies the aponeurosis of
the iliac fascia, behind the circumflex iliac
artery, of which we see the tract.
Place where the aponeui-osis of the fascia
transversalis forms the posterior margin of
the inguinal canal, and goes to unite itself
to the outer side of the tendon of the rectus
muscle.
Upper orifice of the inguinal canal formed by
the transversalis fascia, in the middle of
which this last aponeurosis becomes funnel-
shaped in the inguinal canal.
Bundle of fibres which form the lower and
inner portion of the superior orifice of the
inguinal canal.
Epigastric artery with its two veins placed
within the superior orifice of the inguinal
canal, first under the peritoneum, after-
wards entering the sheath of the rectus
muscle.
The vas deferens, reflecting itself at an acute
angle on the inferior part of the superior
orifice of the inguinal canal, and on the
epigastric vessels.
The spermatic artery with its two veins pass-
ing through the inguinal canal.
Superior orifice of the crural canal, formed
on the outer side by
The aponeurosis of the iliac fascia, and on the
inner side by
Gimbernaut's ligament,
Falciform edge of Gimbernaut's ligament,
b".
b'"
c.
d.
f. f.
g- g-
h. h.
h. h
1. 1.
J- J-
k. k.
1.
m.
m'.
n.
0.
P-
q. q.
r. r.
y-y-
Portion of the ligament adhering to the crural
arch,
Portion of the ligament adhering to the crest
of the pubis,
Branch of the epigastric artery passing a little
above Gimbernaut's ligament.
Posterior side of the superior orifice of the
crural canal, formed by the ascending ra-
mus of the pubis.
Anterior side of the superior orifice of the
crural canal, formed by the crural arch, on
the level of the inguinal canal.
External iliac artery situated opposite the ex-
ternal parietes of the superior orifice of the
inguinal canal, and giving off the epigas-
tric and circumflex iliac arteries.
External iliac vein giving off the two epigas-
tric veins.
The external iliac and psoas muscles united.
Crural nerve.
Aponeurosis of the iliac fascia.
External iliac artery enclosed in a small
sheath formed by the junction of the iliac
and transversalis fascia;.
Cellular tissue under the peritoneum of the
right internal iliac fossa.
The bladder drawn to the right, and falling a
little down from its wanting the support of
the rectum.
Hook applied to the bladder.
Plexus of the vesical veins.
Seminal vesicle of the left side joined to the
vas deferens.
Ascending ramus of the pubis.
Internal obturator muscles.
The levator muscles of the anus.
Pelvic fascia.
Obturator hole traversed by its vessels and
nerves.
Place where the pelvic fascia lies upon the
internal obturator muscle.
Place where the pelvic fascia lies upon the
levator muscle of the anus.
Place where the pelvic fascia, on its external
aspect, gives off a fibrous expansion which
descends between the two last muscles.
Place where the aponeurosis which covers the
internal aspect of the internal obturator
muscle divides into two layers, viz.
Fibrous layer, which covers the inferior aspect
of the levator anus,
Fibrous layer, which descends on the internal
aspect of the internal obturator muscle, to
fix itself to the tuberosity of the ischium.
Pudic vessels and nerves enclosed in a small
sheath formed by the preceding aponeurosis.
Anus and inferior part of the rectum, embrac-
ed by the superior and inferior aponeuroses
and the levator muscle of the anus.
Fatty cushion placed between the anus and
the tuberosity of the ischium in an apo-
neurotic angle, formed partly by the aponeu-
rosis of the internal obturator muscle, and
partly by that which covers the lower part
of the levator muscle of the anus.
PLATE XI
■■■
PLATE ELEVENTH.
INTERIOR OF THE PERINEUM AND CAVITY OF THE PELVIS, TO SHOW THEIR APONEUROSES.
A. Section of the pubis, a little to the outer side of
the symphysis.
B. B. Lateral section of the sacrum and last lumbar
vertebrae.
C. Bundles of lumbar and sacral nerves enclosed in
the spinal canal.
D. D. Section of the spine of the sacrum.
E. Last intervertebral ligament.
F. F. Fleshy mass of the sacro-spinal muscles.
G. Aponeurosis of the sacro-spinal muscles.
H. Aponeurosis of the great dorsal united to the pos-
terior fibres of that of the transverse.
I. I. Subcutaneous tissue.
J. The skin.
K. Penis.
L. Scrotum.
M. Hair of the pubis.
N. Hook applied to the rectus muscle.
O. Epigastric artery.
P. P. Crest of the ilium.
Q. Iliac muscle.
R. Psoas magnus muscle.
5. Tendon of the psoas minimus muscle.
T. End of the aorta.
U. Left common iliac artery.
V. External iliac artery.
X. Internal iliac or hypogastric artery.
Y. Obturator artery.
Z. Glutaeal artery.
6. Sciatic and internal pudic arteries.
J-
k.
1.
m.
n.
o. o.
Cord of the umbilical artery.
Vesical arteries.
End of the inferior vena cava.
Left common iliac vein.
External iliac vein.
Cut trunk of the internal iliac or hypogastric vein.
One of the branches of the obturator vein ending
in the external iliac, at the middle of the crural
arch, a distribution very common, if not con-
stant.
The rectum thrown outwards.
The bladder also thrown outwards.
The left seminal vesicle.
The prostate visibly covered by a prolongation of
the pelvic aponeurosis which forms its sheath.
Superior perineal aponeurosis.
Pubo-prostatic ligament formed by the superior
perineal aponeurosis.
Notch for the passage of veins.
Arch of the levators of the anus, formed by the
pelvic fascia, and giving rise to the lesser pel-
vic fascia.
Obturator hole.
Obturator nerve.
Sacro-sciatic notch, in which we observe the
glutaeal artery, and near to which we find the
glutasal nerve.
Sciatic notch, traversed by the sciatic and internal
pudic arteries.
PLATE TWELFTH.
FIGURE FIRST.
Crural Hernial Sac removed, to shotv the hole by
which it descends in the Female.
Seat of the pubis.
Crural arch extending towards the ilium.
Abdominal muscles.
Crural arch.
Fascia lata.
Semilunar edge of the fascia lata.
Third insertion of the external oblique.
Crural artery.
Crural vein.
Crural sheath.
Abdominal ring.
The orifice by which the crural hernia descends,
formed on the outer side by the crural sheath,
on the inner by the semicircular insertion of
the tendon of the external oblique, and above
in part by the crural sheath and in part by the
semilunar edge of the fascia lata. The division
in the crural hernia is made at the upper and
inner part.
A.
B.
C. <
D.
E.
F.
G.
H.
I.
K.
L.
M.
A.
B.
C. C.
D.
E.
F.
G. G.
H.
I.
K.
L.
M.
N.
O.
P.
Q.
FIGURE SECOND
Shows the Crural Sheath.
Pubis.
Ilium.
Abdominal muscles drawn up.
Transversalis muscle.
Its tendon.
Seat of the posterior edge of the crural arch.
Fascia transversalis.
Inner portion of the same fascia.
Fascia iliaca.
Crural sheath.
Crural artery.
Crural vein.
Saphena major vein.
Anterior crural nerve.
Fascia lata turned back.
Tendon of the external oblique muscle drawn
down.
FIGURE THIRD.
Dissection of a Case of Inguinal Hernia, to shotv
the Coverings of the Sac and relative situations
of the Vessels.
A. A. Inguinal ring of the left side.
B. B. Tendinous bands, which cross the direction of the
fibres of the aponeurosis of the external oblique
near the inguinal ring.
C. C. C. Aponeurosis of the external oblique muscle of
the abdomen, cut from the crest of the ilium,
from the linea alba, and from the vicinity of
the inguinal ring.
D. Crural arch of the left side.
E. E. Aponeurotic and membranous sheath, formed by
the cremaster muscle, laid open ; the borders of
the opening are held asunder by two hooks.
F. Continuation of the sheath formed by the cremas-
ter muscle, in which are enclosed the spermatic
cord and tunica vaginalis of the testicle.
G. G. Fleshy fibres of the cremaster muscle.
H. H. Cellular tissue, soft and pliant, which forms an
intermediate cushion between the cremaster
muscle and hernial sac.
I. I. Hernial sac formed by the peritoneum.
K. K. Portion of the omentum contained in the hernial
sac.
L. L. Sheatb of the rectus muscle of the left side open-
ed and reflected.
M. Portion of the great peritoneal sac, the transpa-
rency of which permits us to distinguish the
convolutions of the intestines.
N. The rectus muscle of the left side reflected on the
right side of the abdomen.
O. The internal oblique muscle of the left side.
P. Portion of the great peritoneal sac appearing un-
der the crural arch of the left side, after having
separated the aponeurosis of the fascia lata,
and elevated the Fallopian ligament.
Q. Skin of the scrotum.
li. Femoral artery.
S. Femoral vein.
T. Anterior iliac artery.
U. Origin of the epigastric artery.
V. V. Tract of the epigastric artery of the left side,
along the rectus muscle, after having passed
behind the hernial sac.
X. Origin of the epigastric vein.
Y. Y. Tract of the epigastric vein behind the neck of
the hernial sac, and along the rectus muscle.
Z. Saphena vein.
a. Anterior crural nerve.
b. Curved dotted line, which indicates the direction
followed by the viscera in passing through the
canal, to form the external inguinal hernia,
which is the more common.
c. Glutasus medius muscle.
d. Fascia lata.
e. Sartorius muscle.
f. Rectus muscle.
g. Vastus externus muscle,
h. Iliacus internus muscle.
i. Tendons of the adductor muscles of the thigh,
i. Gracilis muscle.
PLATE XII
Fia. I
'■
PLATE XIII.
T> T f> S
■
PLATE THIRTEENTH.
VIEW OF THE PERINEUM IN THE MALE.
A.
B.
B.
C.
C.
1).
D.
D'
D. D
E.
F.
F.
G.
H
H.
I.
J.
J.
K.
L.
L". L".
L"'. L'
M.
M'.
N.
N*.
O.
P.
P.
L"\
Penis.
Testicles and their envelopes.
Portion of the inner sides of the thighs, on
which the aponeurosis is exposed.
Portion of the gluteus maximus muscle.
Section of the skin and subcutaneous cellu-
lar tissue.
Coccyx.
Portion of the skin of the buttock.
Hook applied to the glutseus maximus mus-
cle of the right side, to show the subja-
cent parts.
Tuberosities of the ischia.
Portion of the right great sacro-sciatic li-
gament.
Rami of the pubis.
Symphysis of the pubis.
Inferior or superficial aponeurosis of the
perineum, detached in front and on the
sides, drawn down, twisted on its base,
and thrown to the left.
Place where the inferior perineal aponeuro-
sis connects itself with the middle (R).
Lateral border of the inferior aponeurosis of
the perineum, which was attached to the
corresponding ramus of the arch of the
pubis at the middle of the dotted line J.
Threads and hook applied on the anterior
part of the inferior perineal aponeurosis.
Superficial artery and nerve of the perineum
close to the inferior perineal aponeurosis,
and displaced by the drawing out of the
aponeurosis.
Dotted line indicating the natural position
of these vessels and nerves.
Cavernous body, with erector penis muscle.
Cavernous body cut across, and penetrated
in the centre by its vessels.
Spongy portion of the urethra.
Acceleratores urinae muscles.
Posterior insertion of the muscle on the
superior aspect of the inferior perineal
aponeurosis.
Q.
R.
R'.
S.
S'.
T.
T\
U.
V.
V.
X
Y.
X. X. X.
Y.
Y'. Y\
Z.
Transverse muscle of the perineum proceed-
ing obliquely in front to the bulb of the
urethra.
Anterior portion of the middle perineal
aponeurosis.
Notch below the symphysis of the pubis,
formed in part by the middle perineal
aponeurosis, and giving passage to the
vein, arteries, and nerve of the dorsum
of the penis.
Notch formed purposely in the middle pe-
rineal aponeurosis, to show, above it, the
superior branch of the internal pudic
artery, and the transverse artery of the
perineum.
Artery of the cavernous body.
Cavernous body.
Artery and nerve of the dorsum of the
penis.
Vein of the dorsum of the penis proceeding
towards the notcli R'. of the middle pe-
rineal aponeurosis.
Anus.
Sphincter of the anus.
Coccygean extremity of the sphincter of
the anus.
Inferior hemorrhoidal vessels and nerves.
Posterior portion of the middle perineal
aponeurosis, which is here inferior ; the
inferior aponeurosis existing only in
front.
Place where some fibres of the gluteus
maximus take their origin from the pre-
ceding aponeurosis.
Pelvic aponeurosis, lying on the internal
aspect of the internal obturator muscle.
Angular sinus, formed by the reunion above
of the preceding aponeurosis of the in-
ternal obturator muscle, and of the pos-
terior portion of the middle aponeurosis.
The sinus is crossed by the inferior he-
morrhoidal vessels and nerves X. X. X. X.
and filled in the fresh state by a fatty
cushion.
PLATE FOURTEENTH.
SECTION PARALLEL TO THE AXIS OF THE BODY; OF THE PERINEUM, OF THE PELVIC
PORTION OF THE ANTERIOR ABDOMINAL PARIETES, AND OF THE POSTERIOR
SACRAL REGION; MADE A LITTLE TO THE OUTER SIDE OF THE MESIAL LINE.
J'.
K. K.
L.
M.
N.
«o.
O'.
p.
P'.
Q.
R.
T. T.
U.
V.
X.
Y.
Z.
b. b.
A. Symphysis of the pubis.
B. Penis, lying upon the belly.
C. Buttock.
D. Thigh.
E. Umbilicus.
p. Section of the inferior part of the spine.
(J, Skin and subcutaneous tissue of the perineum.
(J', Cord attached in front to the skin of the peri-
neum.
G". Hook applied behind to the skin of the peri-
neum.
H. Superficial or inferior perineal aponeurosis.
JJ', Posterior border of the inferior perineal aponeu-
rosis, continuous with the inferior aspect of
the middle aponeurosis.
J Place where the accelerator urina; muscle in-
serts itself on the superior aspect of the in-
ferior perineal aponeurosis.
J. Place where the sphincter muscle of the anus
inserts itself on the inferior aspect of the in-
ferior perineal aponeurosis.
Sphincter muscle crossed by small hemorrhoi-
dal veins.
Superficial vessels and nerves of the perineum.
Accelerator urinaj muscle.
Right testicle exposed.
Urethra.
Root of the cavernous body untouched.
Root of the cavernous body divided.
Anterior portion of the middle perineal aponeu-
rosis.
Posterior portion of the middle perineal aponeu-
rosis, inferior at this point.
Inferior hemorrhoidal vessels and nerves.
Origin of the superficial vessels and nerves of
the perineum.
Transverse artery of the perineum, cut at its
origin and visible as far as the bulb, in con-
sequence of a slit in the middle perineal apo-
neurosis, which is entire below.
Levator muscle of the anus.
Origin of the membranous portion of the ure-
thra.
Prostate.
Triangular fleshy fibres, which arise from the
pubis under the pubo-prostatic ligaments, em-
bracing laterally the urethra and prostate, on
the envelope of which the fibres terminate.
Pubo-prostatic ligament.
Bladder.
Anterior aspect of the bladder where the peri-
toneum is wanting, and which comes in con-
tact with the pubis and with the abdominal
parietes when the bladder is much distended.
Cut edge of the peritoneum, which covers the
posterior, and a part of the superior and in-
ferior aspects of the bladder,
c. The bottom of the recto-vesical depression of
the peritoneum, about two inches and a half
distant from the surface of the skin,
il. Urachus, arising from the summit of the blad-
der, and slipping under the peritoneum of
the anterior abdominal parietes.
d'. Ligament of the right umbilical artery.
e. e. Branches of the prostatic plexus of veins form-
ed by the vesical veins and those of the pe-
nis, which pass under the symphysis pubis,
e'. e'. Cut ends of two prostatic and vesical veinous
P-
q.q.
t. t.
t'.
1.
2.
3. 3.
4.
3.
G. 6.
7. 7. 7.
8. 8. 8.
9.
10. 10.
11. 11.
12.
13.
14-.
15.
16.
branches, which terminate in the hypogastric
vein.
Vesico-prostatic arterial branches.
Vesical artery.
Ureter crossed superiorly and on the inner side
by the vas deferens.
Spermatic vesicle slightly raised.
Vas deferens below and on the inner side of the
corresponding vesicle.
Rectum, of which we see principally the part
deprived of peritoneum and the longitudinal
muscular fibres scattered uniformly upon its
surface.
Inferior portion of the rectum, or anus.
Place where the rectum and prostate are united
by condensed cellular substance.
Lesser hemorrhoidal vessels.
Superior hemorrhoidal vessels, branches of the
inferior mesenteric vessels.
Hypogastric portion of the anterior abdominal
parietes, which comprehends,
The skin,
Aponeurosis of the fascia superficialis,
Anterior portion of the sheath of the rectus
muscle,
Rectus muscle,
Tendon of the rectus muscle,
Pyramidalis muscle enclosed in a small sheath,
formed by a redoubling of the anterior part
of the sheath of the rectus muscle,
Aponeurotic fibres, sometimes wanting, which,
when they exist, separate the rectus and py-
ramidalis muscles,
Posterior portion of the sheath of the rectus,
Place where the posterior part of that sheath is
wanting, the rectus muscle coming in con-
tact with the peritoneum, or the bladder,
according to circumstances,
Peritoneum lining the anterior abdominal pa-
rietes, and reflecting itself below upon the
bladder,
Space where the bladder, deprived of perito-
neum, comes in contact with the anterior
abdominal parietes.
Posterior sacral region, which comprehends,
The skin,
Subcutaneous cellular substance,
Aponeurosis, formed by the union of the great
dorsal aponeurosis and the posterior fibres of
the aponeurosis of the transverse muscle of
the abdomen,
Aponeurosis of the sacro-spinalis muscle,
Origin of the sacro-spinalis, common mass of
the sacro-lumbalis, and longissimus dorsi
muscles.
Sections of the transverse processes of the ver-
tebra?.
Intervertebral ligaments.
Bundles of lumbar and sacral nerves.
10. Apertures for the passage of the spinal nerves.
11. Sections of the bodies of the vertebra? and sa-
crum.
Cellular tissue which unites the rectum to the
anterior aspect of the sacrum, and to the
coccyx.
Termination of the aorta.
Termination of the inferior vena cava.
Left common iliac artery.
Left common iliac vein.
H* v*>.
I'LATK XIV.
T
ti.atexv:
PLATE FIFTEENTH.
GENITOURINARY ORGANS IN THE FEMALE.
A. A.
B. B.
C. C.
D.
E.
F.
G. G.
H.
I. I.
J'.
K.
L. L.
L'. LA
L".
V"
The thighs.
Buttocks.
Inferior portion of the anterior abdominal parietes.
Umbilicus.
Anterior commissure of the vulva.
Anus.
External labia drawn outwards.
Clitoris drawn forwards and upwards, and on
which we perceive its artery and nerve.
Rami of the pubis, on which we distinguish the
roots of the cavernous bodies of the clitoris and
erector muscles.
Meatus urinarius, of which the prominence, at
its lower part, is serviceable for guiding the in-
troduction of the catheter.
Vagina.
Vestibule.
Spincter muscle of the vulva.
The two anterior bundles of the sphincter muscle
attached to the roots of the clitoris.
Posterior extremity of the sphincter muscle, sepa-
rated from the sphincter of the anus by the
origin of the inferior perineal aponeurosis.
Fibres of the sphincter of the vulva, which em-
brace the meatus urinarius in the form of a
sphincter.
M.
N.
O. O.
P. P.
Q.
R.
Anterior extremity of the sphincter of the anus.
Cut edge of the inferior perineal aponeurosis, and
situation where it furnishes points of insertion
to the sphincter muscles of the vulva and
anus.
Anterior part of a depression placed on the side
of the anus, and filled with fat.
Superficial or vulvar branch of the internal pudic
artery and nerve, which sends branches towards
the anus, and vagina, and principally to the ex-
ternal labia.
Right side of the perineum, on which we have
left the lesser aponeurosis, of which we dis-
tinguish the transverse fibres.
Deep branch of the internal pudic vessels and
nerve of the right side, seen only through the
middle perineal aponeurosis.
The same branch on the left side lying exposed,
the aponeurosis having been entirely removed.
Transverse artery of the perineum.
Arterial arch, placed at the root of the clitoris,
which is sometimes cut in the median opera-
tion for lithotomy, recommended by M. Du-
bois.
*
I'.
m
i-
\
I.
**?
J
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